What is the best management strategy for a 54-year-old woman with elevated liver enzymes, alkaline phosphatase, and ultrasound findings suggestive of biliary obstruction due to gallstones in the common bile duct?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board

Educational purpose only • Exercise caution as content is pending human review

Article Review Status

Submitted

Under Review

Approved

Last updated: January 21, 2026 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Related Questions

Will liver function tests be abnormal in patients with biliary colic?

What is the diagnosis for a patient with alkaline phosphatase (ALP) levels higher than aspartate transaminase (AST)/alanine transaminase (ALT), suggestive of biliary obstruction?

In an adult without prior medical history presenting with 12‑hour upper abdominal pain, nausea, normal skin and sclera, deep abdominal tenderness, and ultrasound showing multiple gallstones, normal gallbladder wall, no pericholecystic fluid, and a common bile duct stone, what is the most likely diagnosis?

Is epigastric pain with hyperbilirubinemia, elevated liver enzymes, and hyperlipasemia, along with acute calculus cholecystitis on ultrasound, consistent with possible choledocholithiasis?

What is the next step for a female patient presenting with right upper quadrant (RUQ) pain, jaundice, elevated direct bilirubin (Dbil), total bilirubin (Tbil), alkaline phosphatase (ALP), and fever, with a temperature of 38.6 degrees Celsius?

What is the management plan for a pediatric patient with severe acute malnutrition on F75 (Formula 75) feeding?

What is the recommended dopamine dose for a patient in shock, considering factors such as weight, age, and medical history?

What is the appropriate dosage of Eliquis (apixaban) for a patient with a history of atrial fibrillation, arm venous thrombosis, and recent gastrointestinal bleeding, who was previously on therapeutic Fragmin (dalteparin) and is now being re-initiated on Eliquis at 2x2.5mg?

What is the appropriate dosing of Eliquis (apixaban) for an 80-year-old dialysis-dependent patient with a history of atrial fibrillation, arm venous thrombosis, and recent gastrointestinal bleeding, considering their impaired renal function?

What is the likelihood of pulmonary embolism (PE) in a patient with a history of atrial fibrillation, venous thrombosis, and recent gastrointestinal bleeding, who is experiencing oxygen saturation drops to severe hypoxemia without oxygen and increased sleepiness?

What is the recommended dose of sulbactam (a beta-lactamase inhibitor) for a patient with multi-drug resistant (MDR) Acinetobacter infection, considering factors such as age, weight, and impaired renal function?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.